Practical Decision Making in Health Care Ethics

by Devettere, Raymond J.

• ISBN13: 9780878407637
• ISBN10: 0878407634
• Edition: 2nd
• Format: Paperback
• Copyright: 2000-02-01
• Publisher: Georgetown Univ Pr

Summary

Devottere (health care ethics, Emmanuel College and Boston College) begins with an overview of ethical theory and argues for his own Aristotleian position before going on to apply this view to a wide range of issues within medical ethics. This second edition includes new chapters on managed care and medical genetics, as well as an extended chapter on virtue and decision making. It also addresses bioethical controversies which have arisen since the publication of the first edition, such as late-term abortion, cloning, germ-line genetic research, the human genome project, brain death, non-heart-beating organ donors, and physician-assisted suicide.

Author Biography

Raymond J. Devettere teaches health care ethics at Emmanuel College and Boston College.

Table of Contents

Preface	xiii
Preface to the Second Edition	xv
Introduction	xvii
What Is Ethics?	1	(25)
Defining Ethics	1	(8)
Two Kinds of Ethics	9	(1)
Historical Versions of the Ethics of Obligation	10	(4)
Moral Reasoning and the Theories of Obligation	14	(3)
Contrasting the Ethics of Obligation with an Ethics of the Good	17	(1)
Retrieving the Ethics of the Good	18	(3)
Bioethics Today	21	(2)
Suggested Readings	23	(3)
Prudence and Living A Good Life	26	(36)
The Good	26	(2)
Happiness	28	(9)
Moral Virtue	37	(4)
Prudence	41	(16)
Suggested Readings	57	(5)
The Language of Health Care Ethics	62	(29)
Distinctions That Can Mislead	64	(16)
Helpful Distinctions	80	(7)
Suggested Readings	87	(4)
Making Health Care Decisions	91	(36)
Complexity of Health Care Decisions	91	(4)
Decision-Making Capacity	95	(4)
Informed Consent	99	(12)
Advance Directives	111	(6)
The Patient Self-Determination Act	117	(2)
The Case of Hazel Welch	119	(3)
Final Reflections	122	(2)
Suggested Readings	124	(3)
Deciding for Others	127	(35)
Becoming a Proxy	128	(4)
Standards for Making Proxy Decisions	132	(6)
Deciding for Older Children	138	(8)
Deciding for the Mentally Ill	146	(10)
Deciding for Patients of Another Culture	156	(1)
Final Reflections on Deciding for Others	157	(2)
Suggested Readings	159	(3)
Determining Life and Death	162	(36)
The Classical Conceptual Framework	164	(9)
A New Conceptual Framework	173	(3)
When Does One of Us Begin?	176	(3)
When Does One of Us Die?	179	(12)
Ethical Reflections	191	(2)
Suggested Readings	193	(5)
Life-Sustaining Treatments	198	(37)
Ventilators	199	(2)
The Case of Karen Quinlan	201	(6)
The Case of Brother Fox	207	(3)
The Case of William Bartling	210	(5)
The Case of Helga Wanglie	215	(6)
Dialysis	221	(1)
The Case of Earle Spring	222	(5)
Surgery	227	(1)
The Case of Rosaria Candura	228	(3)
Other Life-Sustaining Treatments	231	(1)
Suggested Readings	232	(3)
Cardiopulmonary Resuscitation	235	(35)
Terminology	236	(1)
A Brief History of Resuscitation Attempts	236	(1)
The Effectiveness of Attempting CPR	237	(2)
Learning to Withhold CPR	239	(1)
Important Ethical Elements for a DNR Policy	240	(3)
XYZ Hospital Policy for ``Do Not Resuscitate'' Orders	243
DNR Policy	207	(39)
Lingering Questions about DNR Orders	246	(5)
The Case of Maria M.	251	(4)
The Case of Shirley Dinnerstein	255	(3)
The Case of Beth	258	(3)
The Case of Catherine Gilgunn	261	(6)
Suggested Readings	267	(3)
Medical Nutrition and Hydration	270	(34)
The Techniques and Technologies	270	(2)
Conceptualizing Medical Nutrition and Hydration	272	(2)
The Case of Clarence Herbert	274	(5)
The Case of Claire Conroy	279	(5)
The Case of Elizabeth Bouvia	284	(5)
The Case of Mary O'Connor	289	(4)
The Case of Nancy Cruzan	293	(8)
Suggested Readings	301	(3)
Reproductive Issues	304	(41)
Contraception and Sterilization	305	(14)
Medically Assisted Pregnancy	319	(16)
The Case of Baby M	335	(5)
Suggested Readings	340	(5)
Prenatal Life	345	(35)
Abortion	346	(17)
Maternal-Fetal Conflicts	363	(1)
The Case of Angie	364	(5)
Using Fetal Tissue	369	(6)
Suggested Readings	375	(5)
Neonatal Life	380	(40)
Historical Background	381	(2)
A Sampling of Neonatal Abnormalities	383	(5)
Special Difficulties in Deciding for Neonates and Small Children	388	(3)
The Baby Doe Regulations	391	(6)
The Case of Baby Doe	397	(4)
The Case of Baby Jane Doe	401	(4)
The Case of Danielle	405	(7)
The Case of Baby K	412	(5)
Suggested Readings	417	(3)
Euthanasia and Physician-Assisted Suicide	420	(46)
Historical Overview	420	(5)
Recent Developments	425	(2)
Court Battles	427	(4)
Relevant Distinctions	431	(3)
Moral Reasoning and Euthanasia	434	(2)
Reasons for Euthanasia and Physician-Assisted Suicide	436	(2)
Reasons Against Euthanasia and Physician-Assisted Suicide	438	(14)
The Case of Diane	452	(7)
Concluding Reflections	459	(1)
Suggested Readings	460	(6)
Medical Research	466	(47)
Notorious Examples of Questionable Ethics in Research	467	(6)
Reactions to the Questionable Medical Research	473	(9)
Research on Embryos and Fetuses	482	(9)
Research on Minors	491	(1)
Research in Developing Countries	492	(2)
The Case of Controversial AIDS Research	494	(6)
Other Special Populations in Research	500	(1)
The Case of Compound Q	501	(3)
Animals and Medical Research	504	(4)
Suggested Readings	508	(5)
Transplantation	513	(39)
Transplantation of Organs from Dead Human Donors	515	(13)
The Case of Jamie Fiske	528	(2)
The Case of Jesse Sepulveda	530	(5)
Transplantation of Organs from Living Human Donors	535	(5)
Transplantation of Organs from Animals	540	(1)
The Case of Baby Fae	540	(5)
Implantation of Artificial Hearts	545	(3)
Suggested Readings	548	(4)
Medical Genetics	552	(41)
Genetic Testing	556	(3)
A Case of Concern About Cancer	559	(6)
A Case of Premarital Worry	565	(7)
Genetic Screening	572	(4)
Gene Therapy	576	(7)
Genetic Enhancement	583	(3)
Human Genome Project	586	(7)
Suggested Readings	588	(5)
Managed Care	593	(27)
Historical Background	593	(6)
The Managed Care Revolution	599	(6)
The Case of James Adams	605	(12)
Suggested Readings	617	(3)
Glossary	620	(9)
Index of Cases	629	(2)
Subject Index	631